Which is the preferred image modality for paediatr

Authors: Zoë Lawson Diane Nuttall Stephen Young Sam Evans Sabine Maguire Frank Dunstan Alison M Kemp

Publish Date: 2010/12/07

Volume: 125, Issue: 6, Pages: 825-830

PDF Link

Abstract

Images of bruises serve as a clinical record and may facilitate forensic analysis in the assessment of suspected physical child abuse Currently only conventional imaging techniques are employed however alternative imaging modalities using visible and nonvisible light may provide additional information We sought to determine the image modality preferences of paediatricians and the betweenobserver agreement therein Nine paediatricians who work in child protection independently compared five image modalities conventional colour conventional greyscale crossPolarised ultraviolet and infrared of four bruises with a compliance rate of 95 All images were taken using a standardised set of protocols with Nikon D90 cameras and 105mm macrolenses The paediatricians almost unanimously chose crossPolarised as their preferred modality for all four bruises when assessing boundary shape colour size and absence of light reflectance Conventional colour and greyscale imaging were typically ranked second and third Ultraviolet and infrared were consistently ranked in the least two favourable positions Betweenobserver agreement on ranking order was high with coefficients of concordance ranging from 076 to 096 Combinations of imaging modalities chosen to give the most complete picture of the bruise predominantly consisted of crossPolarised and conventional colour and greyscale This pilot study demonstrated that clinicians collectively favoured crossPolarised in addition to conventional imaging Further studies are required to determine the value of ultraviolet and infrared imaging in the assessment of childhood bruisesThe authors would like to acknowledge and thank all members of the PROTECT project team and the successful collaboration between the Schools of Primary Care and Public Health Child Health and the Dental Illustration Unit at Cardiff University and the Media Resources Centre at the University Hospital of Wales We would also like to thank members of the Cardiff and Vale University Hospital Board child protection team for participating in the study

Keywords: